Doctors and families also lied to patients, or at least didn’t tell them the whole truth.
In the late 1940s, when my mother was in high school, her best friend died from cancer. 
She was told that she had “a growth on her kidney”, but they didn’t fool her. She knew.
(sic)
When time permits, I transcribe cemetery records from the 18th and 19th century for genealogy purposes. I’ve been doing that for years. Many cemeteries kept good records, when the records survived, and listed family members and causes of death.
I’m always struck by the number of people who died from consumption (tuberculosis) - often several members of a family within months of each. You could almost make that the default cause of death when inputting the data, and change it when you encountered something else. A lot less typing that way. 
Smallpox, particularly in the 18th century, seemed to sweep through families in various pockets at some points in time. In my own family tree, several members of the same family died within a month of each other - grandparents, child, and grandchild, all dead from smallpox in January and February 1779.
In the 19th century into the very early 20th century, you still see a good amount of tuberculosis, but also lots of cholera and typhoid. There were pockets of scarlet fever (strep infection). There is the occasional cancer, but it’s rarely the cause of death because people died of acute diseases before cancer had a chance to set in - diseases that are largely treatable today or have been averted by sanitation and water treatment.
I expected to see more accidents, but it was not as big a contributor to death as the diseases mentioned above (again, just anecdotal, based on a transcribing several thousand old records from cemeteries). You get the occasional “kicked in the head by a horse” or accidents involving horse-drawn wagons or ox carts, but they are fairly rare - rarer than I expected.
I always get a kick out of those unexplained and vague causes of death. They seem curious today, like when a 60 year old person’s cause of death is listed as “old age” and nothing else.
As you move into the late 19th century, you get more detailed information. Instead of “old age”, you see more “apoplexy” (stroke) and various coronary-related causes, such as “hardening of the arteries” or more specific diagnoses of heart defects.
There were occasional diagnoses of cancer in death records, mostly in people over 50 or 60. When I saw things like “intestinal obstruction”, I assumed it was probably cancer-related. Again, it was mostly in the post-50 and post-60 crowd, because that’s when most problems kick in.
Since cancer is most often a disease of age, many people died from common diseases that were not treatable at the time, and they died long before you would see them reach an age where cancer would become a widespread problem.
What about various lung problems, including cancer, from cooking on open fires? Melanomas before the advent of sun block? Although I suppose that’s what all the hats were for.
I’m afraid there are two components to the explanation here, at the time it was quite common to not tell women in particular about their medical conditions. My grandmother got cancer of the thyroid. The doctor diagnosed it and told her husband and he and the doctor agreed to remove it. This was effective at curing the cancer, but at the advice of the doctor my grandfather never told his wife what had happened. So she had problems due to a thyroid issue she didn’t even know existed. She didn’t learn until years later, after the divorce, which itself was a scandal at the time.
Melanoma wasn’t a big problem before CFCs blew a hole in the ozone layer.
Hats and long sleeves and long skirts and pants and tights/leggings under shorter pants…and siestas, which took people indoors during the most dangerous parts of the day.
A lot of cancers present with vague symptoms until the patient succumbs to something else - like pneumonia or a stroke - and dies with their cancer intact. It wasn’t until modern imaging that we could find things like pancreatic cancer while the person was still alive. You’d just record the immediate cause of death, “pneumonia,” and not the unknown cancer. Even today, many people with cancer die of other things, and that’s what on their death certificate. Difference now is that their cancer is diagnosed and logged so we know more about how many people have it during their lives, if not the cause of death.
Indeed. For many, many cancers, there would be no way to know without modern diagnostic and imaging techniques.
Take my dad, who has terminal esophageal cancer. He began with vague heartburn that gradually got worse and worse until he was having trouble eating any food at all, losing a great deal of weight, and only able to eat very soft or liquid foods. Because this was 2015, endoscopy and PET scans revealed a cancerous tumour. If this was 1415, he would have wasted away in short order and if his death had been recorded anywhere it would have been listed as “wasted away” or “digestive complaint.” Nowhere would it have been recorded that it was cancer, but that wouldn’t have made it any less cancer.
This. I suspect this kind of thing is the case with melanoma - no one thought to tie the black spot on someone’s skin to the fact that they died of the effects of metastasis to the brain, bowel, lung, or elsewhere. Many historians think Henry VIII’s first wife, Catherine of Aragon, died of melanoma that had spread to her heart - she did have an autopsy, and a ‘black growth’ on her heart was noted. It’s also thought that another of his wives, Anne of Cleves, died of endometrial cancer. (The Tudors kept very good medical records, apparently.) His daughter, Mary, also likely died of endometrial or ovarian cancer. This stuff was around, but the understanding of causes and relationships between cause of death and other symptoms was often not well understood.
Certain professions did have high death rates like fishermen and whalers were as high as 17% and I read where on Nantucket about 25% of the married women had been widowed at least once. No wonder seamen are so suspicious.
In early 1960’s Pakistan,my grandfather went in for routine surgery and they discoeverd a cancerous growth. The surgeon came out and asked my grandmother; they agreed that it should be removed and it was…my grandfather did not find out until much later. Thats would be all sorts of illegal today.
Moral of the story; don’t presume that actions taken reprseneted standard behaviour, just that it might have been due to circumstance peculiar to that case. (In my grandfathers case, he was a nuclear scientist, I think my grandmother had an exceptional fear of cancer there).
The ozone layer “Holes” generally occur in the polar regions and the persistent one is over the Antarctic, where nobody lives.
The banning of CFCs has been effective at preventing further ozone depletion and has probably prevented a substantial amount of cancer.
Don’t forget food poisoning!
The word “cancer” means “crab” in Greek, and the disease was named that for the presentation of untreated breast cancer, which apparently looks like a crab attached to the breast.
Melanoma is associated with acute exposure to the sun, and sun burn, not with total lifetime sun exposure. It is still uncommon among farmers, who get a lot of basal cell and squamous cell skin cancers, which are associated with total sun exposure rather than with acute sun exposure.
I’ve seen estimates that as many as 1 in 3 men will develop prostate cancer at some point in our lives. It’s just that, for most of us, it’s so slow-growing that it wouldn’t kill us until age 120 or something like that.
Of course, doctors are reluctant to diagnose such cases, because if the cancer really is growing that slowly, the best treatment is none at all… but a patient is likely to panic and demand treatment if they hear the C-word.
Seconded; this was a great book. In it he talks about very old historical records of cancer diagnoses, e.g. in BC Egypt and medieval England. Not to say it was more/less common back then (though as noted upthread it was probably very underdiagnosed in the past), but it was around.
Melanoma wasn’t a big problem because people used to cover up out of modesty. 200+ years ago, you didn’t leave the house without covering pretty much everything except your face and hands. The result? Far less sun exposure than people typically get today. Health officials these days advocate sunblock usage, but they’d probably be less adamant about it if people weren’t spending hours and hours in the sun with large areas of skin exposed.
I wonder how many of the people who died from “indigestion” actually had myocardial infarctions. Lots of them, probably.
Based on what we’ve seen in isolated populations at the turn of the 20th century, cancer appears to have been exceptionally rare until more recently:
Dr. Robert McCarrison, who spent 9 years living in the Himalayas wrote in JAMA in 1922:
Physician Ales Hrdlicka observed Native Americans from 1898-1905 and wrote:
In 1923, Colonel surgeon F.P. Fouche who had been stationed in Africa wrote:
In 1935 J.A. Urquhart, who lived along side of the Inuit in northern Canada, wrote:
More here:
Another updated perspective on the antiquity record, FWIW.
FWIW I suspect that industrialization dramatically increased cancer rates. But I’d be hesitant to make any conclusions from the data we have.
This meta-analysis found that 59% of men aged 80 and over, who died of other causes, had incidental prostate cancer detectable in autopsy. Don’t know how that translates into lifetime prevalence, but you’re right, it’s going to happen to a lot of us and most of us will never know.
Huh. In English-language food recipes, “lights” are animal lungs.
Never heard of it used with people. Expected a euphemism only at table. I wonder if the word “light” for lungs is correlated–or originating–in other languages.
“Rising of the Lights” is a very evocative/poetic phrase, I think, when its medical meaning is unknown.